For centuries, it has been held that communication of an ominous prognosis has the power to kill patients and that the cultivation of hope, even when deceitful, may expedite recovery (Faden, Beauchamp, and King 1986, 63). Today, truth is considered a higher value than the pleasantness of no-worry. Research shows that patients want to be told the truth and that informed patients do not die prematurely; rather, they fare better psychologically than those kept behind a veil of silence. We also (...) know that throughout their illness, patients want their caregivers to communicate hope as well. Doctors and patients do not want “hope [to] be taken away” (Schneiderman 2005). Hope (tiqva) is not an independent concept .. (shrink)

In its first part, the paper explores the challenge of conceptualizing the Thomist theological virtue of hope in Aristotelian terms that are compatible with non-Thomist and even atheist metaphysics as well. I argue that the key concept in this endeavor is friendship—as an Aristotelian virtue, as relational value in Thomist theology, as a recognized value in supportive care and as a kind of ‘personal hope.’ Then, the paper proceeds to examine the possible differences between hope as a virtue and hope (...) as an experience reported by people, terminal patients in particular. With the clinical problem of hope at the end of life in mind, the paper concludes with two meta-ethical questions—about the overridingness of .. (shrink)

In this study, I seek to provide an accurate account of the subjective experience of the body in anorexia nervosa, and how this differs from nonpathological experiences of the body, while remaining neutral on the disorder’s causes. By applying an understanding of the body as found in the work of Merleau-Ponty and Sartre, I show how the insights provided by these philosophers can help to clarify the subjective experience of the disorder. I build up this account of the experience largely (...) by focusing on first-hand accounts of the disorder, as discussed in memoirs and interviews. In doing this, I intend to show one way in which phenomenological insights can prove to be useful in our understanding of psychiatric .. (shrink)

Dr. Lacewing’s paper is a very interesting one. We agree in part, but only in part. Lacewing (2012) rejects the general thesis that “causal inferences must always be justified on the basis of Mill’s canons” (p. 199). I agree, but so does his target, Adolf Grünbaum, as we shall see in a moment. But first there is a question about Grünbaum’s alleged reliance on Mill’s Methods of Agreement and Difference. This interpretation may not make a difference to Lacewing’s arguments, but (...) it is worth correcting, given that some philosophers criticize both methods and yet their criticisms have no direct bearing on any of Grünbaum’s arguments. When Grünbaum speaks of “Millian methods,” he is not necessarily talking .. (shrink)

Michael Lacewing’s argument in this paper is impressive. His basic case is that research in social and clinical psychology threatens to undermine Hopkins’ (1988) well-known defense of psychoanalysis. This defense claims that psychoanalysis is an extension of, and as valid as, commonsense psychology. By questioning the reliability of commonsense psychological inferences, research in social and clinical psychology also challenges psychoanalytic validity. For, in extending commonsense psychology, psychoanalysis inherits its flaws. This is a fascinating contribution to arguments about psychoanalytic epistemology. Lacewing (...) deepens his contribution by attempting to respond to this challenge. He identifies .. (shrink)

Michael Barilan’s article “From Hope in Palliative Care to Hope as a Virtue and a Life Skill” is an interesting and informative contribution to the debate on the nature of ‘a good death.’ Broadly speaking, the author seeks to explore “the roles and meanings of promotion focus goals in human life” and how hope can aid in alleviating suffering (Barilan 2012, 171). The subject is topical and courtesy of being clinically active, Barilan is able to add a welcome perspective. Very (...) briefly, the article sets out to develop a more inclusive idea of hope, involving ‘personal freedom’ and ‘valuation.’ for example, and then proceeds to explore the role of hope, in this version, for the patients in palliative care .. (shrink)

In this paper, I consider an argument offered by Hopkins (1988) regarding the nature and status of our everyday inferences from other people’s behavior to their motives and other mental states. (It may be that we recognize, rather than infer, immediate intentions and emotional states, for example, in bodily actions and facial expressions. But I am concerned with inferences that go beyond states that can be recognized immediately in this way.) Hopkins’ argument seeks to rebut the charge, leveled by Grünbaum, (...) that psychoanalysis cannot justify its inferences regarding motives using its own (clinical) methodology. Hopkins and Grünbaum agree that inferences to motives are causal inferences. Grünbaum argues that only .. (shrink)

I am very grateful to both Edward Erwin and Peter Fonagy for their thoughtful and engaging comments. I do not have space to deal fully with all the issues they raise, but I will try to clarify some key points at which perhaps I implied more than I intended, or failed to be clear. Erwin states that I claim the following principle is a method for inferring causes: “if X is causally relevant to the occurrence of Y, then the incidence (...) of Ys in the class of Xs and Ys will be different compared with the incidence of Ys in the class of non-Xs and Ys” (Erwin 2012, 217). This is not so. The method I attribute to Grünbaum is given in what follows the principle in the quotation given on p. 199, namely, “To validate a .. (shrink)

According to Bowden (20121), anorectics’2 bodily experiences are characterized by a “corporealization,” which has notably been described as follows: “The exchange with the environment is inhibited, excretions cease; processes of . . . shrinking, and drying up prevail” (Fuchs 2005, 99). What is described here is melancholia, but a similar characterization would be applicable to anorexia. I think, however, that the notion of ‘corporealization’ is not fine-grained enough to capture the specificity of anorexic/pathological bodily experiences. To develop this point, I (...) here propose to apply some of Heidegger’s key notions to the conceptualization of bodily experience (Caron 2008). As currently defined, the .. (shrink)

Barilan’s (2012) essay “From Hope in Palliative Care to Hope as a Virtue and a Life Skill” provides a novel way of exploring hope as experienced by people at the end of life. He proposes that hope can be usefully seen as an Aristotelian virtue; something to be “conscientiously chosen” as a “habit of behavior, perceptiveness and mental response, holistically considered” (Barilan 2012, 166). Hope coalesces with other virtues, particularly courage, in the terminally ill, to enable human flourishing even at (...) this time of great uncertainty, loss, and ultimately personal annihilation. The virtue of hope in an individual might manifest itself in various ways, particularly in creativity and caring relationships. .. (shrink)

Anastasia Scrutton offers an attractive account of two Christian theologies of depression and argues, cogently and compellingly, that forms of potentially transformative theologies are therapeutically and philosophically superior. My double aim here is to try to cash out the operative notion of 'transformation' by focusing on two features: first its multimodal character (ethical, aesthetic, existential, spiritual) and, second, the theme of a realisation of 'dependence', 'grounding', or of being 'anchored' in the world. I suggest that these two themes of multimodality (...) and dependence can be understood, individually and together, if they are placed within an aretaic framework. The transformative effects of suffering consist of the cultivation and exercise of virtues - of being edified - in a way that transforms both one's character and one's relationship to the world. To be transformed by suffering is therefore to be edified and this account shows fidelity to both the case studies Scrutton discusses and to wider features of the Christian tradition. The paper ends by sketching out answers to Scrutton's questions about whether transformative suffering applies to somatic as well as to mental illness, and whether it provides a theodical justification of human suffering. (shrink)